Arts Psychotherapy (Complex Emotional Needs)

We offer arts based psychodynamic therapies for adults in community mental health teams in Edinburgh and East Lothian, taking a Mentalization Based Treatment (MBT) focus. We also have teams in Inpatient Mental Health Services and CAMHS across the Lothians.

Arts Psychotherapists are psychological professionals that comprise Art Therapists, Music Therapists and Dramatherapists, registered by the Health & Care Professions Council (HCPC). We provide treatment primarily for patients with Complex Emotional Needs, who exhibit moderate to severe symptoms of emotional distress. This includes patients that have experienced significant adverse life events and self-report difficulties in emotional-regulation, anxiety, self-harm and maintaining their sense of self and relational capacity.

A challenge across mental health services is the ‘missingness’ of patients; individuals with complex needs who are frequently excluded from treatment pathways or who repeatedly disengage from offers of care and support. This includes people who may find traditional psychological therapies inaccessible, overwhelming, or overly reliant on verbal communication.

Our arts-based interventions are specifically designed to address these barriers. By using the creative modalities of visual art, music and drama, we enable participants to express experiences and emotions without needing to find the “right words”. This non-verbal, relational approach helps reduce the pressure often associated with conventional talking therapies and creates a more inclusive, accessible entry point into care. We encourage relational thinking and awareness for our patients, who report improvements in emotional regulation, confidence, social interaction and the ability to develop coping mechanisms. Evidence from our service demonstrates a significantly improved engagement profile, and our programmes show a Did Not Attend (DNA) rate of less than half the national average for routine psychological therapies.

We take a collaborative, and personalised approach with patients to treatment goals and delivery of treatment, in line with the principles of Realistic Medicine (values-based care). We link into Community based Arts Programmes as way of supporting patients to find strategies for recovery that go beyond mental health service provision.

Please note we are a small service, and referrals can only be made from inpatient, locality or specialist mental health teams.

For general queries and PROFESSIONAL USE ONLY please contact: loth.adminartspsychotherapiess@nhs.scot.

Treatment Services:

REFERRAL CAN ONLY BE MADE FROM THE ASSOCIATED SPECIALIST TEAMS.

Mentalization Based Arts Psychotherapy Treatment (MBT) Programme (EUPD) (Edinburgh Only)

Our specific MBT programme is offered within Edinburgh Community Mental Health Teams (CMHTs). It provides people who attract a diagnosis of Emotionally Unstable Personality Disorder (EUPD) with a programme of Arts Psychotherapy oriented Mentalization Based Treatment (MBT) to reduce symptom severity and improve relational functioning. The programme is in 3 stages:

• Assessment & Co-formulation (3 weeks)
• MBT based Arts Psychotherapy Psychoeducation Group focussed on EUPD diagnosis (10 weeks)
• MBT based Arts Psychotherapy processing group (12 months).

For more details, please see – Mentalization Based Arts Psychotherapy Treatment (EUPD) – RefHelp

Arts Psychotherapy Outpatient Treatment Programme (East Lothian)

Arts based psychodynamic treatment with a Mentalization (MBT) and relational focus for adult patients with Complex Emotional Needs, including those otherwise excluded from Psychological Therapies Services, such as patients that attract a diagnosis of C-PTSD and EUPD, psychosis and/or neurodevelopmental conditions such as Autism and/or ADHD.

The following is offered:

• Assessment, Co-Formulation and Crisis Support Plan
• MBT based Arts Psychotherapy Psychoeducation Group
• Individual and Arts Psychotherapy treatment groups taking an MBT focus (with regular reviews).

Arts Psychotherapy Treatment for patients with an eating disorder

This can be offered as part of the out-patient eating disorders treatment service. Arts Psychotherapy uses a Mentalization (MBT-ED) focus that has been modified to address the core mentalizing and relational difficulties linked to the eating disorder, allowing an increase of epistemic trust, promoting social learning and improving interpersonal functioning. ^{1 (see Resource and Links for references)}

This may be effective for patients with additional Complex Emotional Needs such as a diagnosis of complex trauma or personality disorder, or in the case of inadequate response to standard treatments, if mentalizing deficits, interpersonal difficulties, and attachment insecurity are clearly related to the clinical presentation.

• Individual and closed Mentalization based Arts Psychotherapy treatment groups (with regular reviews).

Referral is via the Lothian Eating Disorders Service (LEDS) if thought appropriate at assessment.

Arts Psychotherapy Home Treatment Programme – Intensive Home Treatment Team (IHTT)

Art Psychotherapy is offered as part of the home-based mental health service, where short term intensive community-based care is a viable alternative to admission to hospital for patients living with a mental health crisis. Evidence from our service evaluation suggests that Arts Psychotherapy with a Mentalization (MBT) focus reduces the intensity and distress associated with assessment, enabling patients to better engage in ongoing treatment and make use of community resources, particularly where they might struggle to engage with more verbal psychological treatments.

Assessment and brief therapeutic intervention (1-3 sessions).

Arts Psychotherapy Inpatient Treatment Programmes

We offer a range of arts based psychodynamic treatments across inpatient settings inNHS Lothian. Using a Mentalization (MBT) focus we aim to enhance relational capacity and reduce levels of distress for patients unable to engage with more standardised treatments or to engage with their care team. We take a mentalization and attachment-based approach to support patients in understanding their diagnosis, symptoms, and associated interpersonal problems, and how this may impact their inpatient experience. We work with patients through their inpatient journey, maintaining a focus on discharge and how to support patients and their families to live and thrive relationally beyond inpatient services.

Our Inpatient Service locations:

Acute Mental Health, Older Peoples Mental Health, Intellectual Disabilities, Psychiatric Rehabilitation, Forensics, Palliative Care, and Neurorehabilitation at the Royal Edinburgh Hospital, St John’s Hospital, East Lothian Community Hospital, Edinburgh Home Based Complex Clinical Care (HBCCC) and Crookston Care Home, East Lothian. 

The inpatient services offered include:

• Individual Assessment and MBT Co-Formulation
• Individual self-exploratory session (Acute)
• Individual sessions focussed on strengthening relational capacity (Rehab only)
• Ward based Open Access Group focussed on distress reduction and building reflective capacity.

The above are accessible as part of the multi-disciplinary interventions available in Inpatient Acute and Rehabilitation wards.

C.M, S.M & K.P – 21-8-26